Nov 22, 2004Nov 22, 2004
Undergraduate Medical EducationUndergraduate Medical EducationONCOLOGY BLOCKONCOLOGY BLOCK
Undergraduate Medical EducationUndergraduate Medical EducationONCOLOGY BLOCKONCOLOGY BLOCK
Nov 22, 2004Nov 22, 2004
PProject to roject to AAdvance dvance CClinical linical EEducationducation“Keeping PACE with the health care needs of our region”“Keeping PACE with the health care needs of our region”
PProject to roject to AAdvance dvance CClinical linical EEducationducation“Keeping PACE with the health care needs of our region”“Keeping PACE with the health care needs of our region”
• Medical School: Medical School: 33rdrd & 4 & 4thth year curricula year curricula• New rotations, more ambulatory care, more New rotations, more ambulatory care, more
disease-oriented / patient-oriented (not disease-oriented / patient-oriented (not department-based)department-based)
• New New “Oncology Block”“Oncology Block” rotation rotation– Required in new 4Required in new 4thth year curriculum for all students year curriculum for all students– Not intended to duplicate material, but to expand it to Not intended to duplicate material, but to expand it to
the “next level”the “next level”– Planned for 2006-2007 (pilot run next year?)Planned for 2006-2007 (pilot run next year?)
• Medical School: Medical School: 33rdrd & 4 & 4thth year curricula year curricula• New rotations, more ambulatory care, more New rotations, more ambulatory care, more
disease-oriented / patient-oriented (not disease-oriented / patient-oriented (not department-based)department-based)
• New New “Oncology Block”“Oncology Block” rotation rotation– Required in new 4Required in new 4thth year curriculum for all students year curriculum for all students– Not intended to duplicate material, but to expand it to Not intended to duplicate material, but to expand it to
the “next level”the “next level”– Planned for 2006-2007 (pilot run next year?)Planned for 2006-2007 (pilot run next year?)
Nov 22, 2004Nov 22, 2004
Total Cancer Care ApproachTotal Cancer Care Approach
DiagnosisDiagnosis
PrognosisPrognosis
TreatmentTreatment
Primary TherapyPrimary Therapy--MultimodalityMultimodality
Post TherapyPost Therapy--Surveillance Surveillance
--ConsolidationConsolidation
RelapsedRelapsedDiseaseDisease
Salvage TherapySalvage Therapy-Phase I program-Drug Discovery
Behavioral ResearchBehavioral Research& Palliative Care& Palliative Care
Behavioral Behavioral OncologyOncology
Cancer Control &Cancer Control &PreventionPrevention
Outreach to theOutreach to theCommunityCommunity
HealthHealthOutcomesOutcomes CancerCancer
PatientPatient
Cancer Cancer ControlControl
Risk FactorsRisk FactorsGeneticsGenetics
ScreeningScreeningPreventionPreventionNutritionNutritionLife StyleLife Style
Molecular OncologyMolecular OncologyFunctional GenomicsFunctional Genomics
Functional Functional GenomicsGenomicsImaging Imaging
Modalities:Modalities:NanotechnologyNanotechnology
Nov 22, 2004Nov 22, 2004
Oncology Block: OutcomesOncology Block: OutcomesOncology Block: OutcomesOncology Block: Outcomes
• Fundamentals of oncologyFundamentals of oncology– Tumor biology, carcinogenesis, epidemiology, tumor Tumor biology, carcinogenesis, epidemiology, tumor
markers, pathology, pharmacology, immunology, markers, pathology, pharmacology, immunology, endocrinology, benefits and complications of multimodal endocrinology, benefits and complications of multimodal therapy, prevention (1°, 2°, 3°), screening, staging, therapy, prevention (1°, 2°, 3°), screening, staging, statistics, clinical trials, ethics, pain / suffering, quality of life statistics, clinical trials, ethics, pain / suffering, quality of life issues, end-of-life issuesissues, end-of-life issues
• Multidisciplinary approachMultidisciplinary approach to prevention, to prevention, diagnosis, treatment, support, & rehabilitationdiagnosis, treatment, support, & rehabilitation
• Natural history, diagnosis, and management of Natural history, diagnosis, and management of common cancers (breast, colon, lung)common cancers (breast, colon, lung)
• Conveying difficult newsConveying difficult news
• Fundamentals of oncologyFundamentals of oncology– Tumor biology, carcinogenesis, epidemiology, tumor Tumor biology, carcinogenesis, epidemiology, tumor
markers, pathology, pharmacology, immunology, markers, pathology, pharmacology, immunology, endocrinology, benefits and complications of multimodal endocrinology, benefits and complications of multimodal therapy, prevention (1°, 2°, 3°), screening, staging, therapy, prevention (1°, 2°, 3°), screening, staging, statistics, clinical trials, ethics, pain / suffering, quality of life statistics, clinical trials, ethics, pain / suffering, quality of life issues, end-of-life issuesissues, end-of-life issues
• Multidisciplinary approachMultidisciplinary approach to prevention, to prevention, diagnosis, treatment, support, & rehabilitationdiagnosis, treatment, support, & rehabilitation
• Natural history, diagnosis, and management of Natural history, diagnosis, and management of common cancers (breast, colon, lung)common cancers (breast, colon, lung)
• Conveying difficult newsConveying difficult news
Nov 22, 2004Nov 22, 2004
Oncology Block: ComponentsOncology Block: ComponentsOncology Block: ComponentsOncology Block: Components
• Home BaseHome Base– Program-based; patient-oriented; Program-based; patient-oriented;
multidisciplinary experiencemultidisciplinary experience
• Core ActivitiesCore Activities– Didactic program, mock student tumor Didactic program, mock student tumor
boards, POM/PBL/EBM sessions, journal boards, POM/PBL/EBM sessions, journal club, club, etc.etc.
• Mandatory ExperiencesMandatory Experiences– Mammography, XRT, Pain clinic, Hospice…Mammography, XRT, Pain clinic, Hospice…
• Home BaseHome Base– Program-based; patient-oriented; Program-based; patient-oriented;
multidisciplinary experiencemultidisciplinary experience
• Core ActivitiesCore Activities– Didactic program, mock student tumor Didactic program, mock student tumor
boards, POM/PBL/EBM sessions, journal boards, POM/PBL/EBM sessions, journal club, club, etc.etc.
• Mandatory ExperiencesMandatory Experiences– Mammography, XRT, Pain clinic, Hospice…Mammography, XRT, Pain clinic, Hospice…
Nov 22, 2004Nov 22, 2004
Home BaseHome BaseHome BaseHome Base
• Eligible Programs:Eligible Programs: Breast, GI, GU, Breast, GI, GU, Cutaneous, Thoracic, H&N, GYN, Neuro, Cutaneous, Thoracic, H&N, GYN, Neuro, Sarcoma, Hem/BMT, Psychosocial & Palliative Sarcoma, Hem/BMT, Psychosocial & Palliative Care, Senior Adult Oncology, PathologyCare, Senior Adult Oncology, Pathology
• Preceptors -- CRITICAL: Preceptors -- CRITICAL: to ensure to ensure comprehensive exposure -- screening, dx, comprehensive exposure -- screening, dx, imaging, path, Rx, f/u, prevention, QOLimaging, path, Rx, f/u, prevention, QOL
• Patient-oriented total cancer care, Patient-oriented total cancer care, involving involving all disciplines (surgery, med onc, rad onc, …)all disciplines (surgery, med onc, rad onc, …)
• NOTNOT 1 wk surgery, 1 wk med onc, 1 wk rad onc 1 wk surgery, 1 wk med onc, 1 wk rad onc
• Eligible Programs:Eligible Programs: Breast, GI, GU, Breast, GI, GU, Cutaneous, Thoracic, H&N, GYN, Neuro, Cutaneous, Thoracic, H&N, GYN, Neuro, Sarcoma, Hem/BMT, Psychosocial & Palliative Sarcoma, Hem/BMT, Psychosocial & Palliative Care, Senior Adult Oncology, PathologyCare, Senior Adult Oncology, Pathology
• Preceptors -- CRITICAL: Preceptors -- CRITICAL: to ensure to ensure comprehensive exposure -- screening, dx, comprehensive exposure -- screening, dx, imaging, path, Rx, f/u, prevention, QOLimaging, path, Rx, f/u, prevention, QOL
• Patient-oriented total cancer care, Patient-oriented total cancer care, involving involving all disciplines (surgery, med onc, rad onc, …)all disciplines (surgery, med onc, rad onc, …)
• NOTNOT 1 wk surgery, 1 wk med onc, 1 wk rad onc 1 wk surgery, 1 wk med onc, 1 wk rad onc
Nov 22, 2004Nov 22, 2004
Core ActivitiesCore ActivitiesCore ActivitiesCore Activities
• Didactic Program (~ 5 hrs)Didactic Program (~ 5 hrs)– Introduction to Total Cancer Care (~ 1/2 hr)Introduction to Total Cancer Care (~ 1/2 hr)– Diagnostic modalities (~ 3/4 hr)Diagnostic modalities (~ 3/4 hr)– Cancer Sciences (~ 3 + hrs ? )Cancer Sciences (~ 3 + hrs ? )
• Carcinogenesis / Molecular oncology (RJ ? )Carcinogenesis / Molecular oncology (RJ ? )• Tumor immunology / Cancer vaccines (SD ? )Tumor immunology / Cancer vaccines (SD ? )• Drug discovery (SS ? )Drug discovery (SS ? )• Experimental therapeutics (DS ? )Experimental therapeutics (DS ? )• Risk assessment, detection, intervention (AG ?)Risk assessment, detection, intervention (AG ?)• Health outcomes (PJ ? )Health outcomes (PJ ? )• Cancer prevention & control (TS ? )Cancer prevention & control (TS ? )
• Didactic Program (~ 5 hrs)Didactic Program (~ 5 hrs)– Introduction to Total Cancer Care (~ 1/2 hr)Introduction to Total Cancer Care (~ 1/2 hr)– Diagnostic modalities (~ 3/4 hr)Diagnostic modalities (~ 3/4 hr)– Cancer Sciences (~ 3 + hrs ? )Cancer Sciences (~ 3 + hrs ? )
• Carcinogenesis / Molecular oncology (RJ ? )Carcinogenesis / Molecular oncology (RJ ? )• Tumor immunology / Cancer vaccines (SD ? )Tumor immunology / Cancer vaccines (SD ? )• Drug discovery (SS ? )Drug discovery (SS ? )• Experimental therapeutics (DS ? )Experimental therapeutics (DS ? )• Risk assessment, detection, intervention (AG ?)Risk assessment, detection, intervention (AG ?)• Health outcomes (PJ ? )Health outcomes (PJ ? )• Cancer prevention & control (TS ? )Cancer prevention & control (TS ? )
Nov 22, 2004Nov 22, 2004
Core ActivitiesCore ActivitiesCore ActivitiesCore Activities
• Conveying difficult news (2 hrs)Conveying difficult news (2 hrs)– Video-taped role playing; discussion; analysisVideo-taped role playing; discussion; analysis– Topics:Topics:
• A new cancer diagnosisA new cancer diagnosis
• Staging and prognostic informationStaging and prognostic information
• Treatment optionsTreatment options
• QOL issues (QOL issues (e.g.e.g. mastectomy, colostomy, mastectomy, colostomy, tracheostomy, infertility, amputation, ED, LE)tracheostomy, infertility, amputation, ED, LE)
• End-of-life issues and hospiceEnd-of-life issues and hospice
• Conveying difficult news (2 hrs)Conveying difficult news (2 hrs)– Video-taped role playing; discussion; analysisVideo-taped role playing; discussion; analysis– Topics:Topics:
• A new cancer diagnosisA new cancer diagnosis
• Staging and prognostic informationStaging and prognostic information
• Treatment optionsTreatment options
• QOL issues (QOL issues (e.g.e.g. mastectomy, colostomy, mastectomy, colostomy, tracheostomy, infertility, amputation, ED, LE)tracheostomy, infertility, amputation, ED, LE)
• End-of-life issues and hospiceEnd-of-life issues and hospice
Nov 22, 2004Nov 22, 2004
Core ActivitiesCore ActivitiesCore ActivitiesCore Activities
• Journal Club (2 hrs)Journal Club (2 hrs)– Surg, Med Onc, Rad Onc, Rad, Path, Surg, Med Onc, Rad Onc, Rad, Path,
Statistician, Basic ScientistStatistician, Basic Scientist– Students present; faculty assist w reviewStudents present; faculty assist w review– Demonstrate the role of EBM and critical Demonstrate the role of EBM and critical
review of the literature (statistical methods, review of the literature (statistical methods, study design, data analysis)study design, data analysis)
– Pick hot or controversial topics (Pick hot or controversial topics (e.g.e.g. HRT) HRT)
• Journal Club (2 hrs)Journal Club (2 hrs)– Surg, Med Onc, Rad Onc, Rad, Path, Surg, Med Onc, Rad Onc, Rad, Path,
Statistician, Basic ScientistStatistician, Basic Scientist– Students present; faculty assist w reviewStudents present; faculty assist w review– Demonstrate the role of EBM and critical Demonstrate the role of EBM and critical
review of the literature (statistical methods, review of the literature (statistical methods, study design, data analysis)study design, data analysis)
– Pick hot or controversial topics (Pick hot or controversial topics (e.g.e.g. HRT) HRT)
Nov 22, 2004Nov 22, 2004
Core ActivitiesCore ActivitiesCore ActivitiesCore Activities
• Mock Student Tumor Boards (1.5 hrs x 10)Mock Student Tumor Boards (1.5 hrs x 10)– GU, Melanoma, H&N, GYN, Sarc, Neuro, GU, Melanoma, H&N, GYN, Sarc, Neuro,
Leukemia/Lymphoma, GI, Thoracic, BreastLeukemia/Lymphoma, GI, Thoracic, Breast– Surgery, Med Onc, Rad Onc, Radiology, Pathology, Surgery, Med Onc, Rad Onc, Radiology, Pathology,
Basic Scientist (?), other (Basic Scientist (?), other (e.g.e.g. speech pathologist speech pathologist etcetc))– Only 4-6 cases (real or simulated) selected to discuss Only 4-6 cases (real or simulated) selected to discuss
diagnosis and treatment from a multidisciplinary point diagnosis and treatment from a multidisciplinary point of view (incl risk factors, screening, diagnostic w/u, of view (incl risk factors, screening, diagnostic w/u, staging, Rx, f/u, QOL issues, end-of-life issues, staging, Rx, f/u, QOL issues, end-of-life issues, clinical trials, clinical trials, etcetc))
– One patient chosen for student role-playingOne patient chosen for student role-playing
• Mock Student Tumor Boards (1.5 hrs x 10)Mock Student Tumor Boards (1.5 hrs x 10)– GU, Melanoma, H&N, GYN, Sarc, Neuro, GU, Melanoma, H&N, GYN, Sarc, Neuro,
Leukemia/Lymphoma, GI, Thoracic, BreastLeukemia/Lymphoma, GI, Thoracic, Breast– Surgery, Med Onc, Rad Onc, Radiology, Pathology, Surgery, Med Onc, Rad Onc, Radiology, Pathology,
Basic Scientist (?), other (Basic Scientist (?), other (e.g.e.g. speech pathologist speech pathologist etcetc))– Only 4-6 cases (real or simulated) selected to discuss Only 4-6 cases (real or simulated) selected to discuss
diagnosis and treatment from a multidisciplinary point diagnosis and treatment from a multidisciplinary point of view (incl risk factors, screening, diagnostic w/u, of view (incl risk factors, screening, diagnostic w/u, staging, Rx, f/u, QOL issues, end-of-life issues, staging, Rx, f/u, QOL issues, end-of-life issues, clinical trials, clinical trials, etcetc))
– One patient chosen for student role-playingOne patient chosen for student role-playing
Nov 22, 2004Nov 22, 2004
Core ActivitiesCore ActivitiesCore ActivitiesCore Activities
• POM/PBL/EBM Sessions (1.5 hrs x 4)POM/PBL/EBM Sessions (1.5 hrs x 4)– Topics:Topics: Breast cancer, Lung cancer, Colorectal Breast cancer, Lung cancer, Colorectal
cancer, Pain Management / Palliative Care / Hospicecancer, Pain Management / Palliative Care / Hospice– Case histories and specific objectives provided to Case histories and specific objectives provided to
students at the beginning of the rotationstudents at the beginning of the rotation– Access to “experts” throughout the rotationAccess to “experts” throughout the rotation– Students present at the end of the rotationStudents present at the end of the rotation– Content experts provide feedback, supplement the Content experts provide feedback, supplement the
information, and “wrap-up” the sessioninformation, and “wrap-up” the session– Bibliographies will be available on the webBibliographies will be available on the web
• POM/PBL/EBM Sessions (1.5 hrs x 4)POM/PBL/EBM Sessions (1.5 hrs x 4)– Topics:Topics: Breast cancer, Lung cancer, Colorectal Breast cancer, Lung cancer, Colorectal
cancer, Pain Management / Palliative Care / Hospicecancer, Pain Management / Palliative Care / Hospice– Case histories and specific objectives provided to Case histories and specific objectives provided to
students at the beginning of the rotationstudents at the beginning of the rotation– Access to “experts” throughout the rotationAccess to “experts” throughout the rotation– Students present at the end of the rotationStudents present at the end of the rotation– Content experts provide feedback, supplement the Content experts provide feedback, supplement the
information, and “wrap-up” the sessioninformation, and “wrap-up” the session– Bibliographies will be available on the webBibliographies will be available on the web
Nov 22, 2004Nov 22, 2004
Mandatory ExperiencesMandatory ExperiencesMandatory ExperiencesMandatory Experiences
Students must pick 5 of the following:Students must pick 5 of the following:• Screening at Lifetime (incl seeing a mammogram Screening at Lifetime (incl seeing a mammogram
being done, and doing 3 CBE’s under supervision)being done, and doing 3 CBE’s under supervision)• Genetic Counselling - one consultationGenetic Counselling - one consultation• Radiation Treatment (incl simulation, marking of Radiation Treatment (incl simulation, marking of
fields, designing shields, tattooing…)fields, designing shields, tattooing…)• Oncologic emergencies and medical complications of Oncologic emergencies and medical complications of
cancer and cancer Rx (recommend one full day with cancer and cancer Rx (recommend one full day with one of the PTA/IHM MD’s)one of the PTA/IHM MD’s)
• Palliative care and pain control (recommend one full Palliative care and pain control (recommend one full day in the Pain Clinic +/- interventional anaesthesia)day in the Pain Clinic +/- interventional anaesthesia)
• Hospice in the communityHospice in the community
Students must pick 5 of the following:Students must pick 5 of the following:• Screening at Lifetime (incl seeing a mammogram Screening at Lifetime (incl seeing a mammogram
being done, and doing 3 CBE’s under supervision)being done, and doing 3 CBE’s under supervision)• Genetic Counselling - one consultationGenetic Counselling - one consultation• Radiation Treatment (incl simulation, marking of Radiation Treatment (incl simulation, marking of
fields, designing shields, tattooing…)fields, designing shields, tattooing…)• Oncologic emergencies and medical complications of Oncologic emergencies and medical complications of
cancer and cancer Rx (recommend one full day with cancer and cancer Rx (recommend one full day with one of the PTA/IHM MD’s)one of the PTA/IHM MD’s)
• Palliative care and pain control (recommend one full Palliative care and pain control (recommend one full day in the Pain Clinic +/- interventional anaesthesia)day in the Pain Clinic +/- interventional anaesthesia)
• Hospice in the communityHospice in the community
Nov 22, 2004Nov 22, 2004
AcknowledgmentsAcknowledgmentsAcknowledgmentsAcknowledgments
• Paul Wallach, Paul Wallach, Associate Dean, Curriculum Associate Dean, Curriculum and Medical Educationand Medical Education
• PACE committee membersPACE committee members• Oncology Block committee membersOncology Block committee members
• Special thanks to Yash Patil (ENT) and Special thanks to Yash Patil (ENT) and Jennifer Sparks (MSIV)Jennifer Sparks (MSIV)
• Paul Wallach, Paul Wallach, Associate Dean, Curriculum Associate Dean, Curriculum and Medical Educationand Medical Education
• PACE committee membersPACE committee members• Oncology Block committee membersOncology Block committee members
• Special thanks to Yash Patil (ENT) and Special thanks to Yash Patil (ENT) and Jennifer Sparks (MSIV)Jennifer Sparks (MSIV)
Nov 22, 2004Nov 22, 2004
H. Lee Moffitt Cancer CenterH. Lee Moffitt Cancer CenterH. Lee Moffitt Cancer CenterH. Lee Moffitt Cancer Center